Kidney Donation Linked to Increased Hypertension Risk

Kidney donation is associated with an increased risk for hypertension, according to a study published online in the Clinical Journal of the American Society of Nephrology.

Courtenay M. Holscher, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues compared 1,295 living kidney donors with a median of six years of follow-up to a cohort of 8,233 healthy nondonors. The authors quantified the risk for self-reported hypertension using a parametric survival model. The correlation between hypertension and yearly change in estimated glomerular filtration rate (eGFR) was examined.

The researchers observed an independent association for kidney donation with an increased risk for hypertension (adjusted hazard ratio, 1.19), with no variation by race. There was a mean decline in eGFR for Caucasian and African-American nondonors (−0.4 and −0.3 mL/min/year) that steepened after incident hypertension (−0.8 and −0.9 mL/min/year). After donation, the mean eGFR increased for Caucasian and African-American kidney donors (+0.4 and +0.6 mL/min/year); the increase plateaued after incident hypertension (0 and −0.2 mL/min/year).

"We identified incident hypertension as a risk factor in postdonation eGFR which merits aggressive preventive measures and careful management, as it is associated with cessation of the increase in eGFR following donation," the authors write. "While intuitive, this finding strengthens our understanding of kidney physiology following living kidney donation."

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